The role of hepatitis B core‐related antigen in predicting hepatitis B virus recurrence after liver transplantation

Yu, Jiong; Ye, Yali; Liu, Jingqi; Xu, Yanping; Liu, Bin; Zhu, Jiaqi; Sheng, Xinyu; Feng, Xudong; Pan, Qiaoling; Yang, Jinfeng; Li, Lanjuan

doi:10.1111/apt.15429

Cited by 14 publications

(15 citation statements)

References 44 publications

(96 reference statements)

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“…5.0 log U/mL was an independent predictor of HBV recurrence after liver transplantation, and was superior to HBV DNA level. 36 However, further studies are needed to support these findings.…”

Section: Clinical Implications Of a Role Of Hbcrag In The Natural History Of Chronic Hepatitis Bmentioning

confidence: 97%

Hepatitis B Core-Related Antigen: From Virology to Clinical Application

2021

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Hepatitis B core-related antigen (HBcrAg) is a composite measure of the serum levels of hepatitis B e antigen, hepatitis B core antigen, and a 22-kDa precore protein. It has been shown to reflect the level and transcriptional activity of covalently closed circular DNA in the liver. Longitudinal cohort studies have improved our understanding of the role of this novel viral marker in the natural history of chronic hepatitis B. HBcrAg kinetics reflect the response to peginterferon, and its role in defining guidelines for stopping peginterferon therapy has been evaluated. HBcrAg is a marker of intrahepatic viral activity, which may influence the risk of hepatocellular carcinoma. In this article, we review the virology and role of HBcrAg in defining phases of chronic hepatitis B. Furthermore, the function of HBcrAg in predicting treatment outcomes and its role in monitoring response to novel antiviral agents will be discussed.

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Section: Clinical Implications Of a Role Of Hbcrag In The Natural History Of Chronic Hepatitis Bmentioning

confidence: 97%

Hepatitis B Core-Related Antigen: From Virology to Clinical Application

2021

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“…A long-term follow-up study in Netherlands revealed that higher HBcrAg level (≥5.1 log U/mL) was associated with an increased tumor recurrence rate in 53 of 119 HCC patients who were identified with early stage HCC receiving NAs at the time of HCC diagnosis ( Beudeker et al, 2021 ). Moreover, in a cohort of 357 CHB-related HCC patients who underwent liver transplantation followed by NA treatment, HBcrAg ≥5.0 log U/mL was an independent risk factor for HCC recurrence, with a higher 5-year cumulative recurrence rate, compared with an HBcrAg <5.0 log U/mL (37.6 vs 6%, P < 0.001) (HR:5.27, 95% CI 2.47–11.25, P < 0.001) ( Yu et al, 2019 ). In conclusion, HBcrAg may be a useful biomarker for HCC recurrence, however the sensitivity and specificity of HBcrAg in predicting HCC recurrence needs further research.…”

Section: Serum Viral Biomarkers For Hbv Related Hccmentioning

confidence: 99%

Viral Biomarkers for Hepatitis B Virus-Related Hepatocellular Carcinoma Occurrence and Recurrence

et al. 2021

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Hepatocellular carcinoma (HCC) is the sixth most common cancer worldwide and the fourth leading cause of cancer-related death. The most common risk factor for developing HCC is chronic infection with hepatitis B virus (HBV). Early stages of HBV-related HCC (HBV-HCC) are generally asymptomatic. Moreover, while serum alpha-fetoprotein (AFP) and abdominal ultrasound are widely used to screen for HCC, they have poor sensitivity. Thus, HBV-HCC is frequently diagnosed at an advanced stage, in which there are limited treatment options and high mortality rates. Serum biomarkers with high sensitivity and specificity are crucial for earlier diagnosis of HCC and improving survival rates. As viral–host interactions are key determinants of pathogenesis, viral biomarkers may add greater diagnostic power for HCC than host biomarkers alone. In this review, we summarize recent research on using virus-derived biomarkers for predicting HCC occurrence and recurrence; including circulating viral DNA, RNA transcripts, and viral proteins. Combining these viral biomarkers with AFP and abdominal ultrasound could improve sensitivity and specificity of early diagnosis, increasing the survival of patients with HBV-HCC. In the future, as the mechanisms that drive HBV-HCC to become clearer, new biomarkers may be identified which can further improve early diagnosis of HBV-HCC.

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“…The LT patients were managed according to a standard protocol during follow-up. The patients received immunosuppressive therapy with basiliximab, tacrolimus, mycophenolate mofetil, and prednisolone (prednisolone was used only in patients with non-malignant end-stage liver disease or a history of rejection) [13]. Patients with ABO-incompatible LT were treated with a blood-type barrier consisting of rituximab and intravenous immunoglobulin [14].…”

Section: Management Of Patientsmentioning

confidence: 99%

C-Reactive Protein Is an Independent Predictor of 30-Day Bacterial Infection Post-Liver Transplantation

Shi

et al. 2021

Biomolecules

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The relationship between aseptic systemic inflammation and postoperative bacterial infection is unclear. We investigated the correlation of systemic inflammation biomarkers with 30-day clinically significant bacterial infections (CSI) after liver transplantation (LT). This retrospective study enrolled 940 patients who received LT and were followed for 30 days. The primary end point was 30-day CSI events. The cohort was divided into exploratory (n = 508) and validation (n = 432) sets according to different centers. Area under the receiver operated characteristic (AUROC) and Cox regression models were fitted to study the association between baseline systemic inflammation levels and CSI after LT. A total of 255 bacterial infectious events in 209 recipients occurred. Among systemic inflammation parameters, baseline C-reactive protein (CRP) was independently associated with 30-day CSI in the exploratory group. The combination of CRP and organ failure number showed a good discrimination for 30-day CSI (AUROC = 0.80, 95% CI, 0.76–0.84) and the results were confirmed in an external verification group. Additionally, CRP levels were correlated with bacterial product lipopolysaccharide. In conclusion, our study suggests that pre-transplantation CRP is independent of other prognostic factors for 30-day CSI post-LT, and can be integrated into tools for assessing the risk of bacterial infection post-LT or as a component of prognostic models.

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The role of hepatitis B core‐related antigen in predicting hepatitis B virus recurrence after liver transplantation

Cited by 14 publications

References 44 publications

Hepatitis B Core-Related Antigen: From Virology to Clinical Application

Hepatitis B Core-Related Antigen: From Virology to Clinical Application

Viral Biomarkers for Hepatitis B Virus-Related Hepatocellular Carcinoma Occurrence and Recurrence

C-Reactive Protein Is an Independent Predictor of 30-Day Bacterial Infection Post-Liver Transplantation

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